Hiring and Screening Practices of Agencies Supplying Paid Caregivers to Older Adults

Abstract

Objectives To assess what screening practices agencies use in hiring caregivers and how caregiver competency is measured prior to assigning older adult responsibilities. Design One-to-one phone interviewers where interviewers posed as prospective clients seeking a caregiver for an older adult relative. Setting Cross-sectional cohort of agencies supplying paid caregivers to older adults in Illinois, California, Florida, Colorado, Arizona, Wisconsin, and Indiana. Participants 462 home care agencies were contacted, of which 84 were no longer in service, 165 offered only nursing care, and 33 were excluded. 180 agencies completed interviews. Measurements Agencies were surveyed about their hiring methods, screening measures, training practices, skill competencies assessments, and supervision. Open ended responses were qualitatively analyzed by two coders. Results To recruit caregivers, agencies primarily used print and internet (e.g. Craigslist.com) advertising (n=69, 39.2%) and word-of-mouth referrals (n=49, 27.8%). In hiring, agencies required prior “life experiences” (n=121, 68.8%) of which less (n=33, 27.2%) were specific to care giving. Screening measures included federal criminal background checks (n=96, 55.8%) and drug testing (n= 56, 31.8%). Agencies stated that the paid caregiver could perform medication reminding (n=169, 96.0%).Skill competency was assessed by caregiver self-report (n=103, 58.5%), testing (n=62, 35.2%), and client feedback (n=62, 35.2%). General caregiver training length ranged from 0–7 days. Supervision ranged from none to weekly and included home visits, phone calls, and caregivers visiting the central office. Conclusion Using an agency to hire paid caregivers may give older adults and their families a false sense of security regarding the background and skill set of the caregiver.

Voice‐Controlled Intelligent Personal Assistants to Support Aging in Place

“…Older adults are disproportionately burdened by isolation, chronic disease, cognitive loss, and functional decline, making it difficult for them to safely age in place . Often, family members will fill the role of caregiver to support older adults in their own homes, which results in stress, burden, and financial issues . Interventions are needed to support the needs of this vulnerable population and their caregivers in their homes.…”

“…[4][5][6][7][8] Often, family members will fill the role of caregiver to support older adults in their own homes, which results in stress, burden, and financial issues. [9][10][11] Interventions are needed to support the needs of this vulnerable population and their caregivers in their homes. Voice-controlled intelligent personal assistants (VIPAs; eg, Amazon Echo and Google Home) may be one type of artificial intelligence technology that may improve the lives of older adults in the home setting.…”

Workforce development to provide person-centered care

“…The Training Core for the CMMI award, charged with recruiting, hiring, and training the new CCAs, realized that current hiring practices for older adult direct care workers were insufficient to meet the requirements of person-centered care (Lindquist et al, 2012) and chose to develop a new, rigorous, and innovative screening process to ensure that CCAs possessed the core interpersonal and analytical qualities required to provide excellent person-centered care (Cottingham et al, 2014). For a detailed description of how CCAs were hired utilizing an innovative interviewing and recruitment process and then participated in a six-station Multiple Mini Interview process, developed to simulate challenging scenarios likely to be encountered in real home visits, see Cottingham et al (2014).…”

Fingerprint-based background checks for personal care workers: Stakeholder views of policy criteria

“…The U.S. government requires fingerprint-based background checks for limited sets of individuals in the direct care workforce through Medicare and Medicaid regulations (see Additional Screening Requirements, 2011;CMS, 2013). 2 Studies have examined background check requirements and procedures across states for direct access employees (Borsky, Stewart, Carta, Gritz, & McMahon, 2012), nurses (Alley, Marrs, & Schreiner, 2005), nursing assistants (Lewin Group, 2006), nursing facilities (DHHS Office of Inspector General, 2011), caregiver agencies (Lindquist et al, 2012), and home care workers (Galantowicz et al, 2010). States generally exceed the national requirements for DCW background checks.…”